title: A randomized controlled trial of an appearance-focused intervention to prevent skin cancer.
abstract: BACKGROUND
  Skin cancer represents a significant health threat with over 1.3 million diagnoses, 8000 melanoma deaths, and more than $1 billion spent annually for skin cancer healthcare in the US. Despite findings from laboratory, case-control, and prospective studies that indicate a link between youthful indoor tanning (IT) and skin cancer, IT is increasing among US youth. Appearance-focused interventions represent a promising method to counteract these trends.
  
  
  METHODS
  A total of 430 female indoor tanners were randomized into intervention or no intervention control conditions. Intervention participants received an appearance-focused booklet based on decision-theoretical models of health behavior. Outcome variables included self-reports of IT behavior and intentions, as well as measures of cognitive mediating variables.
  
  
  RESULTS
  Normative increases in springtime IT rates were significantly lower (ie, over 35%) at 6-month follow-up in intervention versus control participants with similar reductions in future intentions. Mediation analyses revealed 6 cognitive variables (IT attitudes, fashion attitudes, perceived susceptibility to skin cancer and skin damage, subjective norms, and image norms) that significantly mediated change in IT behavior.
  
  
  CONCLUSIONS
  The appearance-focused intervention demonstrated strong effects on IT behavior and intentions in young indoor tanners. Appearance-focused approaches to skin cancer prevention need to present alternative behaviors as well as alter IT attitudes. Mediational results provide guides for strengthening future appearance-focused interventions directed at behaviors that increase risk of skin cancer.
authors.affiliation: Department of Community and Behavioral Health, East Tennessee State University, Johnson City, Tennessee 37614, USA. hillhous@etsu.edu
authors.forename: Joel
authors.initials: J
authors.lastname: Hillhouse
authors.forename: Rob
authors.initials: R
authors.lastname: Turrisi
authors.forename: Jerod
authors.initials: J
authors.lastname: Stapleton
authors.forename: June
authors.initials: J
authors.lastname: Robinson
mesh_terms: D000293:Adolescent; D000328:Adult; D001505:Beauty Culture / Q000379:methods; D005260:Female; D015438:Health Behavior; D006266:Health Education / Q000379:methods*; D006801:Humans; D040242:Risk Reduction Behavior; D012878:Skin Neoplasms / Q000517:prevention & control*; D012880:Skin Pigmentation; D012985:Software Design